Cognitive Behavioral Therapy Worksheet for Tayma

Patient Information

• Name: Tayma
• Age: Child
• Sessions Attended: Moderate (6-20 sessions)
• Current Medication: None

Condition Summary

Presenting Issues:

• Mood swings
• Self-harm
• Depressive symptoms
• Oversensitivity

Main Condition:

• Stress Management

Key Issues to Address:

• Family conflict
• Self-esteem improvement

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Goals for Therapy

1. Improve Problem-Solving Skills:
   Learn effective strategies to manage conflicts and emotions.

2. Enhance Self-Esteem:
   Build self-worth and confidence through positive self-affirmation and skills development.

3. Manage Mood Swings:
   Identify triggers and develop coping mechanisms to handle emotional fluctuations.

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Emotional Awareness

Instructions: Recognize and write down your feelings throughout the day. Consider what events triggered these feelings.

Date	Event	Feelings Experienced	Trigger

Reflection Questions:

• What common themes do you notice in your feelings?
• Are there specific situations that consistently trigger negative emotions?

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Cognitive Restructuring

Instructions: Identify negative thoughts that accompany your mood swings and replace them with positive alternatives.

Example Structure:

1. Negative Thought: "I always mess things up."
2. Evidence Supporting Negative Thought: "I didn’t do well on my last test."
3. Evidence Against Negative Thought: "I also helped my friend when they were upset."
4. Balanced Thought: "I have had difficulties, but I also have successes."

Negative Thought	Evidence Supporting	Evidence Against	Balanced Thought

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Behavior Activation

Instructions: Schedule activities that bring you joy and a sense of accomplishment.

Day	Activity	Expected Outcome	Actual Outcome
Monday	Drawing for an hour	Feel relaxed and happy
Wednesday	Helping with chores	Feel helpful and accomplished
Friday	Play with friends	Boost mood and social skills

Reflection Questions:

• Which activities made you feel good?
• How did you feel before and after completing these tasks?

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Problem-Solving Skills

Instructions: Use the following template to outline conflicts and develop solutions.

Conflict Example

• Problem: Family arguments about screen time.
• Options:
  1. Discuss a compromise (e.g., limited screen time).
  2. Propose a family activity that doesn’t involve screens.

Problem	Options	Chosen Solution	Outcome

Reflection Questions:

• How did your chosen solution impact the conflict?
• What would you do differently next time?

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Self-Esteem Enhancement

Instructions: Create a list of strengths and positive qualities about yourself.

My Strengths and Positive Qualities

• I am kind and caring towards others.
• I am creative and enjoy drawing.
• I have the ability to make friends easily.
• I can listen attentively.

Positive Affirmations

Repeat these affirmations daily:

1. I am valuable just as I am.
2. I can manage my emotions effectively.
3. I am learning and growing every day.

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Additional Notes

Tayma is progressing well with therapy. Continued focus on her self-esteem and implementing these strategies will help with her goal of better stress management and emotional regulation. Regular check-ins on her feelings and cognitive restructuring will be crucial in the coming sessions.

Please remember to reflect on your progress frequently and communicate any difficulties in implementing these skills during our sessions together.

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Emergency Contact Details

Please maintain a list of trusted adults to reach out to if you feel overwhelmed.

• Name:
• Relation:
• Contact Number:

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End of Worksheet
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